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Do You Need a Medical Degree to Crowdsource Medicine?

There’s been a lot of talk about crowdsourcing lately. Everything from criminal investigations, to the tax code, to ski resorts have been crowdsourced or considered for crowdsourcing. And now medicine has thrown its hat in this trendy ring. KQED’s “Future of You” recently reported on a company called CrowdMed that wants to be the “Wikipedia of medicine.” (Due to space constraints, this blog post will not engage the important question of whether Wikipedia itself, is, in fact, the Wikipedia of medicine.)

CrowdMed touts itself as harnessing the wisdom of the crowd to improve and expedite diagnosis and treatment for patients whose doctors don’t have the answer. (The company was inspired by the difficulty its founder’s sister had in getting a rare condition diagnosed.) “Patients” pay CrowdMed a subscription fee ranging from $99-$249 per month in order to submit an account of their symptoms and medical history to CrowdMed’s “Medical Detectives.”

The Medical Detectives – who might be physicians or other healthcare professionals, but also might be any average Joe – read patients’ cases, and interact directly with patients to ask questions about their cases.
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A Powerful Tool For ICD9-ICD10 Conversion

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Prior to attending medical school, Parth Desai took a gap year to help his mom manage his dad’s small internal medicine practice.  She was worried about how she was going to handle the looming transition from ICD-9 to ICD-10.  Parth said he would help her out.

He looked at different consultants and programs, but they were all too complicated, too expensive, or both.  He also looked at a number of different ICD-10 training programs, but didn’t really find anything that he thought was that good.  He wanted help with code conversions, but everything he saw was slow, or required additional personnel, or was too costly.

So, he did what lots of entrepreneurs do, he decided to build what he needed himself.  He enlisted his former college roommate, Will Pattiz, a “tech whiz, outdoor enthusiast, and filmmaker” to help him and together they developed software that automates the conversion of ICD-9 to ICD-10 codes. 

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Chelsea Clinton, AMA, Walgreens Headline Health 2.0’s 9th Annual Fall Conference

San Francisco, CA – Health 2.0, the largest global conference and innovation community in digital health announces the agenda for The 9th Annual Fall Conference. The event will host over 3000 attendees and more than 150 LIVE demos in over 35 sessions across 4 days. This year’s exciting line-up features main stage panels on:

  • New technologies for outcomes based care
  • Consumer tools for tracking, rapid diagnostics, and digital therapeutics
  • Big data tools and analytics for smarter health care
  • Data and technology advancing healthy communities
  • The frontier of Health 2.0: robotics, 3-D printing, virtual reality, space medicine and more!

Special Sessions:

  • New technologies for care delivery organizations
  • Launch!  The top 10 brand new companies in health tech
  • Traction — The leading startup business competition in health tech
  • Investment trends and a look inside the biggest deals in digital health

Featured Speakers:

  • Chelsea Clinton, Vice Chair, The Clinton Foundation. Chelsea will speak to women’s health and the work of The Clinton Foundation to strengthen health systems in developing countries, increase opportunities for women and girls around the world, and to help Americans live healthier lives.
  • Dr. Bob Wachter, Professor and Associate Chair of the Dept. of Medicine, University of California San Francisco. Bob will share insights from his latest book “The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Digital Age” which examines the promises, controversies and obstacles in the new digital age of healthcare.

With Other Speakers:

  • Dr. James Madara, President, American Medical Association
  • Robin Thurston, Chief Digital Officer, Under Armour
  • Gregory Orr, Director of Consumer Digital Health, Walgreens

Many more speaker, panel, and session announcements coming soon on the agenda here. Start-up & academic rates are available online on the registration website. Full-time clinicians can apply for free registration.

THCB Registration Now Open

A reminder from the helpful people at THCB’s Tech Support Desk. You can now sign up to join THCB as a full member. (Use the login above.) Membership is free and signing up only takes a few minutes. Registration is required to comment and will qualify you for free stuff, invites to THCB Meet Ups and networking events in your area and more. If you have trouble signing up, use the contact form above at the right or email us at ed****@***************og.com and somebody will walk you through the signup process.  If nothing shows up, before contacting us, it’s a good idea to check your spam filter.

Transparency: Houdini’s last trick

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I recall a talk on imaging biomarkers for Alzheimer’s disease (AD). “Take this with a pinch of salt. I have a financial conflict of interest (COI) in the success of these markers,” the speaker warned. I glanced at the audience – MDs and PhDs with a cumulative IQ higher than the French intake of wine. I looked for pinches. I searched for salt. I found neither.

I wondered what a speaker’s disclosure is supposed to trigger. Should we say “Stop, don’t advance your power point, until we regroup?” Demand that the statistics be re-run in front of us. Challenge, “You say p is 0.04. No, you lying Gordon Gekko, it’s actually 0.06.” Or ask “did you submit ANOVA to Tukey?” If we must ask these questions, must we not ask routinely? Skepticism is a habit, not an episodic righteous angst.

No really, I’m not being facetious, what should transparency make us do differently? His disclosure, paradoxically, made him a saint for his honesty, and gave the audience an excuse to switch off their skeptical neurons, which I suspect had been switched off all along.

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Giving Software Engineers a Seat at the Table


coding is the new literacy

Increasingly, research is becoming available that reveals the weaknesses and strengths of health information technologies.   Everything from infusion pumps to EHR systems have been subjected to analysis.  The new flow of information is wonderful to behold because it wasn’t too long ago that little in the way of actionable HIT research was available.

Research on usability, interoperability, and patient safety can lead to better clinical care software. From these studies, we are learning important information about workflow disruptions, clinician information needs, user interface issues, errors, etc. Now that we have more research, how do we use it to produce better products, to address the needs of HIT users?

Who actually builds HIT products?  Software engineers. They turn feature requests and requirements lists into working software making software engineers a rate-limiting component of any process leading to new products. Therefore, at some point, research must make it into the hands of software engineers who then covert it into objects, methods, APIs, and data store specifications. Continue reading…

Health System Conflict 101

Ok. You know the story. The work we do here at THCB would not be possible without the generous support of our corporate underwriters.  Like Castlight Health and Evolent, Health Catalyst are widely rumored to be bound for an IPO in the near future. They’re a really interesting company, with roots that go back to the fabled IT department at InterMountain Healthcare.  They’ve also been wonderful enough to sign on to support the community here at THCB as Flagship level sponsors. If you love what we do at THCB,  take a few minutes to show you support by taking a look at what they’re up to. Today’s free online session on adaptive leadership in a change of healthcare system conflict is a great introduction.

As you possibly may have noticed, there is a lot of conflict in healthcare. Doctors vs. Nurses. Patients vs. Doctors. Doctors vs. Computers. This online bootcamp will help you deal with it – or at least understand it – and should be required viewing for healthcare leaders, doctors, nurses and other healthcare providers. You will learn effective strategies for leading healthcare system change that will help address resistance to quality improvement, the drivers of negative attitudes, and the way to manage our own personal barriers to change. Well worth your time IMHO. Bring a friend. ; )

The M Word

Insurance carriers large and small have started submitting premium hikes for the next 12 months for approval by federal and state officials. The picture is not pretty particularly for companies that sell the new plans designed under the Affordable Care Act. Those premiums are destined to climb 40 percent or more in some states in 2016.

Health insurance companies are getting squeezed as spending goes up and not enough young, healthy people enroll and pay premiums. As result, healthcare premiums, co-pays, deductibles and out-of-pocket co-insurance costs for individuals, employers and taxpayers will continue to soar ever-higher.

Estimates are that the ACA will add between $140 billion and $500 billion to the deficit over the first decade of the law’s existence. That’s because more will be spent on Medicaid and subsidies than is found in cost savings to healthcare. All truth be told, the ACA did nothing substantive to ensure healthcare cost savings.

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The Dark Age of Meaningful Use

A lesson from the future:

We look back at the years between 2010 and 2016  (The lifespan of Meaningful Use) as a dark age in healthcare software.

It was an era where software companies bound by government mandate to churn out horrible software tried to pretend their products increased productivity. “Eligible” providers were brow-beaten to click buttons and fill forms, print things and perform medical decision making without being paid.

Some software companies were successful, in a financial sense, as their armies of sales experts and market segmenters conquered their unassuming customers, brandishing the sabre of “ONC-ACB certified”. Those companies unwittingly managed to stamp out the potential of small physician offices, increasing consolidation to hospitals – and healthcare costs. Eventually, the ONC crest once emblazoned proudly on their chests, became a warning: “This software was designed for Meaningful Use, not Actual Use”.

Linguistically, the term “Meaningful Use” became entwined with “Electronic Health Record”. People forgot that medical software could improve patient care and not tout it’s Meaningful Use certification. An effort was made to ridicule those who believed that government regulations were legitimately harmful to the healthcare industry. The sky was lassoed and we were pulling it down.

A healthcare IT Renaissance:

The tides did turn, however. Visionaries and industry leaders came to realize how harmful Meaningful Use was to innovation.  Lawmakers were educated on how destructive constantly changing software and workflow requirements are to software development and medical workflow management.Continue reading…

From the People Who Brought You ACOs: A New Model For Healthcare Transformation

farzad_mostashariWhen my co-founder Mat Kendall and I launched Aledade last June, I wrote that our mission was simple: empowering doctors on the front lines of medicine to put them back in control of health care—and rewarding them for the unique value they create. Today, a few days shy of our first birthday, we are announcing that we have raised $30 million in a funding round led by ARCH Venture Partners, and including our Series A funding partners at Venrock. This investment is a testament to the growing demand for our technology-enabled services, and to the rapid progress we have made in creating a platform for doctors to manage the new value-based healthcare economy. But most importantly, it’s a commitment to long-term thinking.

First, we have tapped into a huge unmet need and a growing demand for our healthcare technology services. We hand-picked and signed up 26 practices within weeks of starting the company, and have now established unique partnerships with over 100 primary care practices in 9 states.

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